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Biological Health Hazard – Elizabethkingia anophelis (fatal): Wisconsin (Update 2016-06-22)

2016/06/24

ELIZABETHKINGIA ANOPHELIS – USA (18): (WISCONSIN) FATAL, COMMUNITY ACQUIRED
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Published Date: 2016-06-22 21:46:57
Subject: PRO/EDR> Elizabethkingia anophelis – USA (18): (WI) fatal, community acquired
Archive Number: 20160622.4302947

Date: Monday, 20 June 2016
Source: Healio [edited]

The CDC is still trying to determine why dozens of patients in the Midwest were recently sickened by a rare bloodstream infection caused by the _Elizabethkingia anopheles_ bacterium. “We are still looking for the missing piece,” Maroya S. Walters, PhD, ScM, epidemiologist at the CDC, said at ASM Microbe.

In the largest identified _Elizabethkingia_ outbreak in history, 66 patients in Wisconsin, Michigan and Illinois — most of them older adults — have been infected with the same strain of _E. anopheles_. 63 of these cases occurred in Wisconsin [plus 4 cases where the isolate was not available for genetic analysis – Mod.LL], where the outbreak began last November 2015 and peaked in February 2016. Under increased surveillance, isolates in 11 other states have tested positive for _Elizabethkingia_ — half of them for _E. anopheles_ — but none have matched the outbreak strain, Walters said.

_Elizabethkingia_ bacteria — named for Elizabeth O. King, the CDC bacteriologist who discovered it — are commonly found in the environment in soil, river water and reservoirs. They do not typically cause illness in humans, though Walters said the outbreak investigation revealed that infection is more common than previously thought.

All but one of the patients infected during the outbreak had a serious underlying medical condition, and 32% (n = 21) have died. The median age of the patients was 72 years, 47% (n = 31) were female and 97% (n = 64) were white. The outbreak occurred mostly in a community setting, with 66% (n = 40) of the patients living in a private residence at the time of their initial specimen collection. The most common symptoms were weakness and shortness of breath, Walters said.

Walters said the CDC has not found a source of contamination in health care products, hospitals, food, personal care products, or in patients’ homes, nor has the agency discovered evidence of patient-to-patient transmission. She said the CDC is continuing its search by conducting focus groups among patients who have closely related isolates, who live in the same town, or who share the same occupation, but she said that the investigation might soon end.

“We’re likely coming to the end of the active component of our investigation,” Walters told Infectious Disease News. “We’re doing focus groups to see if we can identify another likely hypothesis because we’d like to find the source of this outbreak, but also because we don’t know if this will come back, and if it does, we’d like to have more hypotheses to test. But once we feel like we are at baseline and we’ve been at baseline for several weeks, it will be the Wisconsin Department of Health Services’ decision whether or not to call off the active part of the investigation.”

[Byline: Gerard Gallagher]

Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[It remains curious that surprisingly little more information is known:
– no information has come out regarding the timeline of cases as to date of onset of illness and location;
– no additional information has been released regarding the recently reported, but older, outbreak of a genetically different strain of _E. anophelis_ in Illinois.

No new cases have been reported in Wisconsin this week (https://www.dhs.wisconsin.gov/disease/elizabethkingia.htm). – Mod.LL

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/250.]

See Also

Elizabethkingia anophelis – USA (17): (WI) fatal, community acq 20160611.4277339
Elizabethkingia anophelis – USA (16): (WI) fatal, community acquired 20160505.4203699
Elizabethkingia anophelis – USA (15): (WI) possible neonatal case 20160429.4190297
Elizabethkingia anophelis – USA (14): (WI) fatal, community acquired 20160427.4187853
Elizabethkingia anophelis – USA (13): (WI,IL) fatal, community acq 20160422.4176668
Elizabethkingia anophelis – USA (12): (WI,IL) fatal, community acq 20160421.4174417
Elizabethkingia anophelis – USA (11): (WI) fatal, community acq 20160415.4162001
Elizabethkingia anophelis – USA (10): (WI, IL) fatal, community acquired 20160413.4158063
Elizabethkingia anophelis – USA (09): (WI) fatal, community acquired 20160408.4146997
Elizabethkingia anophelis – USA (08): (WI) fatal, community acquired 20160331.4129125
Elizabethkingia anophelis – USA (07): (WI,MI) fatal, community acq 20160324.4116626
Elizabethkingia anophelis – USA (06): (WI,MI) fatal, community acq 20160322.4110826
Elizabethkingia anophelis – USA (05): (WI,MI) fatal, community acquired 20160318.4104623
Elizabethkingia anophelis – USA (04): (WI) fatal, community acquired 20160317.4099438
Elizabethkingia anophelis – USA (03): (WI) fatal, community acquired 20160311.4083895
Elizabethkingia anophelis – USA (02): (WI) fatal, community acq., comment, RFI 20160309.4080818
Elizabethkingia anophelis – USA: (WI) fatalities, community acquired, RFI 20160303.4067424
………………………………………….sb/ll/sh

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


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